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J D Pruzansky

Publications and source records attributed to J D Pruzansky.

4 recordsLinked to original sources

Evaluation of recurrent macrodactyly with three-dimensional imaging.

Macrodactyly is a deformity that may progress beyond initial surgical resection. Three-dimensional computed tomography imaging may aid in the surgical planning, given the osseous irregularities that may exist. The objective in revisional surgery of this type is to provide the most functional and cosmetic result. In this case, the hallux was saved when the patient previously had requested an amputation. The case also illustrates that when earlier surgery has been performed, the classic approaches to macrodactyly advocated in the literature may not be feasible. The surgeon must then approach the deformity with some flexibility, and three-dimensional imaging may be a useful tool.

Adult

Digital foot deformities in the arthritic patient.

Relieving pain and preventing deformity in the rheumatoid foot are best accomplished early in the disease course. Although the treatment of digital deformities may not differ significantly in the rheumatoid versus the nonrheumatoid patient, early and more aggressive management is most important in the rheumatoid patient. The digital deformities associated with inflammatory arthritis are progressive as long as the disease is active. Therefore, it becomes necessary to treat these patients both medically and mechanically to slow the progression of the digital deformities. In determining whether medical, surgical, or biomechanical treatment options are appropriate, the physician must examine multiple considerations. These include disease activity, presence or absence of symptoms, degree of deformity and resultant potential for complications, shoe intolerance, and level of activity. Changing attitudes have dictated that little benefit is gained from withholding treatment until the disease is so-called burnt out. It is in the patient's best interest to maintain function whenever possible to allow for increased productivity. The psychosocial ramifications of this approach are obvious.

Arthritis